21 Oct Ambulatory Surgery: The Biggest Change In The Ways Patients Are Treated Today
Ambulatory surgery, also called outpatient surgery, has become much more common today for a number of reasons. Improvements in medical procedures have resulted in patients no longer requiring extended hospital stays during which they can recuperate. Some illnesses and procedures that used to require extensive treatment in the past can now be safely and effectively treated in a shorter period of time without the same risks of side effects. Insurance companies have also limited the number of treatments they will pay for as in-patient care. The area of medicine has also become more specialized so that specialists with an in-depth knowledge of treatments and surgical procedures are available to provide the most effective treatment options on a patient-by-patient basis.
Increased Complexity in Ambulatory Surgery Center Billing
Although the increase in ambulatory surgery centers has eliminated the need for admissions procedures and providing in-patient services, each center must still keep up with the high volume of patients that come and go each day. In addition, there are different surgeons performing, a variety of insurance types to be billed, and coding that applies to all types of insurance to determine what procedure is claimed and reimbursed. In order for an outpatient surgery center to be successful, the ambulatory surgery center billing system used must be extremely efficient and take all areas of the services they provide into consideration so that the revenue cycle is maintained.
Third-Party Ambulatory Surgery Center Billing
The majority of elective surgeries, those not performed out of medical necessity, are performed at ambulatory surgery centers. These surgeries are typically not covered by health insurance and must be paid by the patient. In addition, different insurance policies and insurance companies have guidelines for what they cover, what percentage of the overall charges the patient is responsible for, and what conditions apply. Some companies are specific about the facility where a procedure may be performed. One insurance company may require a specific procedure to be performed in a full-care hospital while others will only cover the procedure as an out-patient service. One of the biggest benefits to hiring a third-party ambulatory surgery center billing company to manage every aspect of your facility’s accounting and billing is having a staff of experts to distinguish the different types of payments and coverage quickly so that more of the medical claims and bills are paid.
Problems with Inside Billing Procedures
There are a number of areas within the ambulatory surgery center where the revenue cycle can become encumbered. Some of these include:
• Failure to collect co-pays and fees upfront
• Mistakes make on claims
• Failing to file claims in a timely manner
• Failing to follow up on claims after they are filed
Most of these centers are high-volume, multi-physician facilities that rely on efficient billing to operate their facility to its maximum potential. A third-party ambulatory surgery center billing company will adhere to the policies and procedures of the center and streamline every area of the revenue management cycle so that the healthcare workers in the clinic can focus on providing the highest level of care to their patients.